Aetna · Montana · commercial in-network

Aetna negotiated rates in Montana

How Aetna's Montana rates compare with the other three national payers, across the procedures that matter most to high-revenue specialties.

Aetna in Montana at a glance

Across 54 procedure codes for 8 specialties
Rate index vs state market
123
23% above the Montana median
Rank in state
1 of 4
Aetna 123 · UHC 114 · Cigna 100 · BCBS 100
vs own national
136
Aetna's level vs its national median
Codes where highest
68%
of 54 codes
80 sampled providers111 TINs54 codesMedian 196% of Medicare · method

What the data shows

Generated from Montana and Aetna data only
1

Aetna ranks 1st of 4 payers in Montana with a rate index of 123 (100 = the Montana market median), across 54 procedure codes.

2

Aetna has the highest median for 68% of codes in Montana.

3

Aetna's Montana rates sit 36% above its own national level, the 5th highest of its 51 states.

4

Largest premium over the Montana market: CPT 72197 (Mri pelvis w/o & w/dye) at 179% of market; largest discount: CPT 99490 (Chrnc care mgmt staff 1st 20) at 56%.

How the four payers compare in Montana

Rate index: 100 = the state four-payer median for the same codes
PayerIndexRankLevelHighest onProviders
Aetna1231
123
68%80
UnitedHealthcare1142
114
69%323
Cigna1003
100
13%367
Blue Cross Blue Shield1003
100
4%409

Where Aetna pays most and least against the Montana market

Codes with the largest gap to the state median

Highest above market

CodeAetnaMarketGapProv.
72197
Mri pelvis w/o & w/dye
$979$546+79%29
77049
Mri breast c-+ w/cad bi
$994$556+79%29
74174
Cta abd&plvs w/contrast
$1,094$616+78%29
72158
Mri lumbar spine w/o & w/dye
$920$518+78%29
70551
Mri brain stem w/o dye
$561$318+76%29
72125
Ct neck spine w/o dye
$369$210+76%29
71260
Ct thorax dx c+
$474$270+76%29
76641
Ultrasound breast complete
$284$162+75%29

Furthest below market

CodeAetnaMarketGapProv.
99490
Chrnc care mgmt staff 1st 20
$44$78-44%22
99215
Office o/p est hi 40 min
$143$226-36%71
99205
Office o/p new hi 60 min
$193$284-32%73
99457
Rpm tx mgmt 1st 20 min
$32$47-32%15
99213
Office o/p est low 20 min
$71$103-31%77
99454
Rem mntr physiol param 16-30
$52$75-30%15
99214
Office o/p est mod 30 min
$107$152-30%77
93306
Tte w/doppler complete
$232$310-25%23

Where Aetna pays above and below its national level

Index vs the payer's own national median (100 = national)

Highest states

StateIndexProv.
Alaska306
211
Idaho152
491
Washington142
708
Mississippi138
608
Montana136
80

Lowest states

StateIndexProv.
Indiana80
698
South Dakota82
147
Florida82
758
Minnesota84
774
North Dakota85
211

Frequently asked questions

Does Aetna pay more or less than the other payers in Montana?

Aetna ranks 1st of 4 in Montana with an index of 123. It is highest on 68% of codes.

Are Aetna's Montana rates above or below its national level?

About 36% above.

Which procedure does Aetna pay most above market in Montana?

CPT 72197 (Mri pelvis w/o & w/dye), at 179% of the Montana median.

Methodology

How these numbers are calculated
  • Source: in-network negotiated-rate files published under the federal Transparency in Coverage rule, August 2026 snapshot: UnitedHealthcare Choice plans (74 files); Aetna commercial plans (70 files); Cigna national PPO (1 files); BCBS licensees' own-network files (5,387 files). Payer comparisons describe these files, not each payer's entire book of business.
  • Sample: rates come from a random sample of up to 150 providers per state and specialty. Counts on this page are sampled providers and TINs, not totals.
  • Which providers count: only providers in a specialty relevant to the code, because a rate in a payer file attaches to a provider group and is listed under every provider in that group.
  • Filters: fee-for-service, professional billing class, no modifier, negotiated or fee-schedule dollar rates. Rates outside 1% to 1,000% of the Medicare rate are excluded.
  • Statistic: one median rate per provider, then percentiles across providers. A cell is shown only with at least 15 sampled providers and 4 TINs.
  • Medicare benchmark: CY2026 national physician fee schedule, non-QPP conversion factor, unadjusted for locality. Where the non-facility rate is more than twice the facility rate (office rates that include device or supply cost), the facility rate is used so comparisons are like for like.

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